Posted by Cam W. on March 4, 2001, at 8:18:50
In reply to What do you think?, posted by adams on March 3, 2001, at 21:32:06
Adams - The choice of which antidepressant (or any drug) for a patient depends upon many factors, starting with a diagnostic questionaire to determine if the person is indeed ddepressed; next a full history (medical and life) including past and present meds and lab tests to rule to drug out drug &/or medical condition-induced depressions. Next you factor in a patient's personality to get a feel for what type of treatments they would prefer (to try to maximize compliance). Sometimes medication is not needed and the depression can be treated with psychotherapy; sometimes both are indicated. Some people aren't able to tolerate certain side effects of treatment (eg nausea & drowsiness with antidepressants or ability to understand and the willingness work on lifestyle changes with psychotherapy). Cost of treatmetns also factors in to whether a person will keep taking therapy (sometimes you have to consider using a cheaper generic TCA,if a person canoot afford newer antidepresssants, with fewer side effects). Patients have to "want" to get better and have to work at it. The patient's role in the treatment of depression is not a passive one, nor is it easy.
Symptom presentation is begininning to guide some docs is choosing certain antidepressants (ie. would this person be helped with a medication that increases serotonin or norepinephrine). The are probably other obvious factors that enter into this equation, but I am a pharmacist, not a diagnostician.
Deciding on a medication or other therapy for the treatment of depression is where a doctors scientific skills and his/her experience come into play. This is a good instance of how the "art" of medicine plays a big role in the selection of a particular therapy for a particular person.
I am sorry that the answer is not as straight forward as you ewould like, but in reality (and in "real" medicine), it isn't. - Cam
poster:Cam W.
thread:55484
URL: http://www.dr-bob.org/babble/20010302/msgs/55515.html